老年男性血清25-羟维生素D及甲状旁腺激素水平与代谢综合征的关系

Correlation of serum 25-hydroxyvitamin D and parathyroid hormone levels with metabolic syndrome in aged males

目的探讨老年男性血清25-羟维生素D[25（OH）D]、甲状旁腺激素（PTH）水平与代谢综合征（MS）及其各组分的相互关系。方法采用横断面研究方法，收集2012年5—6月在解放军总医院行常规年度体检、年龄≥60岁老年男性1729例，平均年龄（75±10）岁。测量身高、体重、血压、血糖、血脂、碱性磷酸酶、血钙和磷、25（OH）D及PTH水平，分析25（OH）D、PTH水平与代谢综合征及其各组分的相互关系。结果本研究人群MS患病率为22．0％（380／1729）。MS组胛H水平为（42±16）ng／L，高于非MS组的（40±17）ng／L，差异有统计学意义（t=0．163，P〈0.05）；高血糖组PTH水平为（42±16）ng／L，高于血糖正常组的（40±17）ng/L，差异有统计学意义（t=0．306，P〈0．05）；低HDL-C组PTH水平为（47±18）ng／L，高于HDL-C正常组的（40±16）ng／L，差异有统计学意义（t=2．724，P〈0．05），而25（OH）D在各代谢异常组与正常组之间比较差异无统计学意义。随PTH五分位水平升高，MS患病率呈增加趋势；当校正25（OH）D等混杂因素后，最高值Q5组与最低值Q1组比，MS患病风险增加1．51倍（95％CI：1．03～2．23）。Logistic多元回归分析表明，PTH是影响MS的危险因素之一（OR=1．007，95％CI：1．000～1．014，P=0．047），25（OH）D与MS无关（OR=1．004，95％CI：0．992～1．016，P=0．538）。结论老年男性PTH水平升高可能增加MS的患病风险，而25（OH）D与MS未见明显相关。

Objective To explore the association of 25-hydroxyvitamin D （25 （OH）D） and parathyroid hormone （PTH） with metabolic syndrome （MS） and its components in aged males. Methods For this cross-sectional study, 1 729 aged males aged over 60 years were selected from participants in a routine annual health examination at our hospital from May to June 2012. Their mean age was 75 ± 10 years. Height, weight, blood pressure, blood glucose, blood lipids, alkaline phosphatase, calcium, phosphorus, 25（OH） D and PTH were measured. And the associations of 25 （OH）D and PTH with the presence of MS and its components were analyzed. Results The prevalence of MS was 22. 0% . The PTH levels were significantly higher in the MS and abnormal blood glucose and HDL-C group than in their control group [ （42 ±16） vs （40 ±17）, （42 ± 16） vs （40 ± 17）, （47 ± 18） vs （40 ± 16） ng/L respectively, P 〈 0.05 ]. However, there were no significant differences of 25 （OH） D between these groups. The prevalence of MS showed a gradual increase according to the PTH quintiles （ P 〈 0. 05 ）. When comparing the subjects in the highest and lowest quintile of PTH, the former group demonstrated a 1.51-fold increase in odds ratio for MS after adjusting for 25 （OH） D levels and other confounding factors. Logistic regression analysis showed that the PTH level was an independent influeneing factor for MS in aged males （ OR = 1. 007, 95% CI： 1. 000 - 1. 014, P =0. 047）. The levels of 25 （OH） D were not associated with MS in the regression model （ OR = 1. 004, 95% CI： 0. 992 - 1. 016, P =0. 538）. Conclusion In aged males, the elevated level of FFH is a risk factor for the prevalence of MS. However, there was no association between 25 （OH） D and MS.